Discordance between genotypic resistance and pseudovirus phenotypic resistance in AIDS patients after long-term antiretroviral therapy and virological failure

2013 ◽  
Vol 54 (10) ◽  
pp. 1120-1125 ◽  
Author(s):  
Jing Yang ◽  
Wenqing Geng ◽  
Min Zhang ◽  
Xiaoxu Han ◽  
Hong Shang
Keyword(s):  
Antiretroviral Therapy ◽  
Virological Failure ◽  
Aids Patients ◽  
Genotypic Resistance ◽  
Phenotypic Resistance

Long-term virological effect of highly active antiretroviral therapy on cerebrospinal fluid and relationship with genotypic resistance

2004 ◽  
Vol 10 (1) ◽  
pp. 52-57 ◽  
Author(s):  
Arabella Bestetti ◽  
Silvia Presi ◽  
Chiara Pierotti ◽  
Simona Bossolasco ◽  
Serena Sala ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Antiretroviral Therapy ◽  
Highly Active Antiretroviral Therapy ◽  
Genotypic Resistance ◽  
Highly Active

scholarly journals Effect of AIDS-defining events at initiation of antiretroviral therapy on long-term mortality of HIV/AIDS patients in southwestern China: a cohort study

2020 ◽  
Author(s):  
Yunxuan Huang ◽  
Oulu Zhou ◽  
Zhigang Zheng ◽  
Yuexiang Xu ◽  
Yi Shao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cohort Study ◽  
Antiretroviral Therapy ◽  
Mortality Risk ◽  
Hiv Positive ◽  
Aids Patients ◽  
Death Risk ◽  
Long Term Mortality ◽  
Hiv Aids

Abstract Objective To evaluate the impact of AIDS-defining events (ADE) on long-term mortality of HIV positive individuals on antiretroviral therapy (ART), a retrospective HIV/AIDS treatment cohort study was performed in southwestern China. Methods The cohort was established based on HIV/AIDS patients on ART recruited in Guigang city, Guangxi, China, from January 2004 to December 2018. Participants were divided into ADE and non-ADE groups, and were followed-up every six months to observe treatment outcomes. Comparison of mortality between groups was performed using the log-rank test and Kaplan-Meier analysis. Cox proportional hazard regression was used to explore the risk factors of mortality. 1:1 propensity score matching (PSM) was used to balance confounding factors and adjust the mortality risk. Results Of 6,757 participants with 29,096.06 person-years of follow-up, 16.86% (1,139/6,757) belonged to ADE group while the others (83.14%) belonged to the non-ADE group. The most common cause of death by ADE was disseminated mycosis (31.65%), followed by recurrent severe bacterial pneumonia (28.48%), herpes zoster(17.72%), and extra-pulmonary tuberculosis (8.86%). The mortality of the ADE group was significantly higher than that of the non-ADE group [3.45/100 person-years (95% CI: 2.92-3.97) vs. 2.34/100 person-years (95%CI: 2.15-2.52), P<0.001]. The death risk of the ADE group was also higher than that of the non- ADE group [adjusted hazard ratio (aHR) =1.291, 95% CI: 1.061-1.571, P =0.011], which was confirmed by PSM analysis (aHR=1.581, 95% CI: 1.192-2.099, P =0.002). Cox analysis indicated that ADE, older age, male gender, previous non-use of cotrimoxazole, advanced WHO clinical stage, and low baseline CD4+ cell count were the risk factors for death. Conclusions Even on ART, the mortality risk of HIV positive individuals with ADE was higher than those without ADE. Active testing, earlier diagnosis, and timely therapy with ART may reduce the death risk of ADE.

scholarly journals Lack of effectiveness of adherence counselling in reversing virological failure among patients on long‐term antiretroviral therapy in rural Uganda

HIV Medicine ◽  
2019 ◽  
Vol 21 (1) ◽  
pp. 21-29 ◽  
Author(s):  
J Birungi ◽  
Z Cui ◽  
S Okoboi ◽  
A Kapaata ◽  
P Munderi ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Virological Failure ◽  
Adherence Counselling

scholarly journals CLINICAL-EPIDEMIOLOGICAL CHARACTERISTIC OF AIDS-ASSOCIATED CRYPTOCOCCOSIS: DIAGNOSTICS AND THERAPEUTIC ASPECTS OF THE PROBLEM

2018 ◽  
Vol 23 (4) ◽  
pp. 156-164
Author(s):  
Alyona Borisovna Konkova-Reidman ◽  
A. A. Veksei ◽  
N. V. Smirnova ◽  
O. A. Pischulova
Keyword(s):  
Antiretroviral Therapy ◽  
Hiv Infection ◽  
Opportunistic Infections ◽  
Antifungal Drugs ◽  
Aids Patients ◽  
Life Threatening ◽  
Cd4 Lymphocyte ◽  
Definition Of ◽  
Chelyabinsk Region

Introduction Currently, cryptococcosis is among the three most life-threatening opportunistic infections in AIDS patients. Materials and methods. The analysis of cases of cryptococcosis in HIV-infected patients in the world, the Russian Federation and the Chelyabinsk region using the methods of descriptive and analytical epidemiology. Two clinical cases of verified cryptococcosis were analyzed in detail in patients in the phase of HIV infection progression in the absence of antiretroviral therapy. Results. The manifestation of the disease was observed in the phase of progression of HIV infection in the absence of antiretroviral therapy with low immune status of patients (CD4 + lymphocyte level less than 100 cells in 1 μl of blood). The diagnosis is verified on the basis of a complex of clinical, instrumental, biochemical, immunological and mycological methods. Successful courses of treatment with antifungal drugs: amphotericin B, itraconazole, fluconazole. Conclusions. The definition of cryptococcal antigen is not a method for evaluating the effectiveness of treatment due to its long-term persistence in CSF and serum, even with successful treatment. Prescribing antiretroviral therapy significantly increases the effectiveness of cryptococcosis treatment. In AIDS patients, antifungal therapy is stopped only after effective for 3-6 months ART (the number of CD4 + lymphocytes in the blood is more than 100-200 cells/μl).

scholarly journals Early Virological Failure in Naive Human Immunodeficiency Virus Patients Receiving Saquinavir (Soft Gel Capsule)-Stavudine-Zalcitabine (MIKADO Trial) Is Not Associated with Mutations Conferring Viral Resistance

2000 ◽  
Vol 38 (7) ◽  
pp. 2726-2730 ◽  
Author(s):  
M. Mouroux ◽  
A. Yvon-Groussin ◽  
G. Peytavin ◽  
C. Delaugerre ◽  
M. Legrand ◽  
...  
Keyword(s):  
Viral Load ◽  
Virological Failure ◽  
Viral Resistance ◽  
Resistance Testing ◽  
Genotypic Resistance ◽  
Phenotypic Resistance ◽  
Genotypic Resistance Testing ◽  
Immunodeficiency Virus ◽  
Group 2 ◽  
Group 1

The MIKADO trial was designed to evaluate the efficacy of stavudine-zalcitabine-saquinavir (soft gel capsule) [d4T-ddC-SQV(SGC)] in 36 naive patients (−3.3 log10units at week 24 [W24]). Among the 29 patients remaining on d4T-ddC-SQV(SGC) until W24, 10 harbored a virological failure (viral load of >200 copies/ml at W24) (group 1). To determine the reasons for therapeutic failure, genotypic and phenotypic resistance test results and SQV concentrations in plasma were analyzed and compared to those in successfully treated patients (viral load of <200 copies/ml at W24) (group 2). Reverse transcriptase and protease genotypic analyses in group 1 revealed the acquisition of only one SQV-associated mutation (L90M) in only two patients. There was no significant increase in the 50 or 90% inhibitory concentration of SQV in patients with or without the L90M mutation. However, the fact that two patients developed an L90M mutation only 4 weeks after relapse points to the need for genotypic resistance testing in the context of an initial failure of the antiretroviral regimen. At W24, the median SQV concentration in group 1 (71 ng/ml) was significantly lower than in group 2 (475 ng/ml), and the plasma SQV concentration was correlated with the viral load at W24 (r = −0.5; P < 0.05) and with the drop in viral load between day 0 and W24 (r = −0.5; P < 0.01). These results and the fact that the plasma SQV concentrations in the two groups prior to relapse (W12) were not significantly different strongly suggest that the early failure of this combination is not due to viral resistance but to a lack of compliance, pharmacological variability, and drug interactions or a combination of these factors.

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